Department of Pharmacology, Lagos State University College of Medicine, Ikeja, Lagos, Nigeria.
Ther Clin Risk Manag. 2013;9:215-21. doi: 10.2147/TCRM.S44205. Epub 2013 May 14.
Drug-drug interactions are an important therapeutic challenge among human immunodeficiency virus-infected patients. Early recognition of drug-drug interactions is important, but conflicts do exist among drug compendia on drug interaction information. We aimed to evaluate the consistencies of two drug information resources with regards to the severity rating and categorization of the potential interactions between antiretroviral and co-prescribed drugs.
We reviewed the case files of human immunodeficiency virus-infected children who were receiving treatment at the human immunodeficiency virus (HIV) clinic of the Lagos University Teaching Hospital, Idi Araba, between January 2005 and December 2010. All of the co-prescribed and antiretroviral drug pairs were screened for potential interactions using the Medscape Drug Interaction Checker and the Monthly Index of Medical Specialties Interaction Checker. Drug-drug interaction (DDI) severity and categorization were rated on a scale of A (no known interaction); B (minor/no action needed); C (moderate/monitor therapy); D (major/therapy modification); and X (contraindicated/avoid combination).
A total of 280 patients were at risk of 596 potential DDIs. The databases showed discrepancies, with Medscape database identifying 504 (84.6%) and USA MIMS database identifying 302 (50.7%) potential DDIs. Simultaneous identification of DDIs by both databases occurred for only 275 (46.1%) listed interactions. Both databases have a weak correlation on the severity rating (rs = 0.45; P < 0.001). The most common DDIs identified by the databases were nevirapine and artemisinin-based combination therapy (170; 28.5%), nevirapine and fluconazole (58; 9.7%), and zidovudine and fluconazole (55; 9.2%). There were 272 (45.6%) interaction severity agreements between the databases.
Discrepancies occurred in DDI listings between Medscape and USA MIMS databases. Health care professionals may need to consult more than one DDI information database to ensure safe concomitant prescribing for HIV patients.
药物相互作用是人类免疫缺陷病毒（HIV）感染患者面临的一个重要治疗挑战。早期识别药物相互作用非常重要，但药物学参考资料在药物相互作用信息方面存在冲突。我们旨在评估两种药物信息资源在评估抗逆转录病毒药物和合并处方药物之间潜在相互作用的严重程度分级和分类方面的一致性。
我们回顾了 2005 年 1 月至 2010 年 12 月期间在拉各斯大学教学医院 Idi Araba 的 HIV 诊所接受治疗的 HIV 感染儿童的病历。使用 Medscape 药物相互作用检查器和每月医学专业索引交互检查器筛选所有合并处方和抗逆转录病毒药物对以确定潜在的相互作用。药物-药物相互作用（DDI）的严重程度和分类按 A（无已知相互作用）; B（轻微/无需采取行动）; C（中度/监测治疗）; D（严重/治疗修改）; 和 X（禁忌/避免组合）的等级进行评分。
共有 280 名患者面临 596 种潜在的 DDI 风险。数据库存在差异，Medscape 数据库识别出 504 种（84.6％），而 USA MIMS 数据库识别出 302 种（50.7％）潜在的 DDI。两个数据库同时识别出的 DDI 仅为列出的相互作用的 275 种（46.1％）。两个数据库在严重程度分级上相关性较弱（rs = 0.45; P <0.001）。两个数据库识别出的最常见的 DDI 是奈韦拉平与基于青蒿素的联合疗法（170 种; 28.5％），奈韦拉平与氟康唑（58 种; 9.7％），齐多夫定与氟康唑（55 种; 9.2％）。两个数据库之间有 272 种（45.6％）相互作用严重程度一致。
Medscape 和 USA MIMS 数据库在 DDI 清单方面存在差异。医疗保健专业人员可能需要咨询多个 DDI 信息数据库，以确保为 HIV 患者安全合并处方。
